Provider Demographics
NPI:1225592579
Name:LYFE N MOTION PT LLC
Entity Type:Organization
Organization Name:LYFE N MOTION PT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIAPATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURROWS-ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-628-6394
Mailing Address - Street 1:3857 IRWIN KUNTZ DR
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-2128
Mailing Address - Country:US
Mailing Address - Phone:504-628-6394
Mailing Address - Fax:
Practice Address - Street 1:3827 SPENCER ST
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5910
Practice Address - Country:US
Practice Address - Phone:504-628-6394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty